By Malak Saddy, RDN, LD
***This is the first of a two-part series that addresses the significance of culture and ethnicity in eating disorders treatment.
Food, religion, culture, and traditions are part and parcel of humans’ daily lives. It is perhaps the most unifying aspect of humanity. Past our bodily needs for nourishment, and sustenance, what, where, how, and perhaps with whom we eat, identifies us. Throughout history religious holidays worldwide have been celebrated with different foods and traditions as part of the gatherings and festivities, with each holiday having its soul dish, or dishes, reflecting that culture’s resources and the ethnicity of its people. Yet, for me it took two decades to appreciate being that unique individual.
The scene at the elementary cafeteria table was always awkward, cautiously pulling out my piece of pita bread, and tub of hummus from my lunchbox, and explaining it to all the girls sitting around me. I winced at the smell of fresh garlic while they were eating their crust-less peanut butter and jelly sandwiches, and sipping on Hawaiian Punch. I was always trying to avoid their repulsion, and stares, finally swallowing it down as quickly as possible in a private moment of humiliation. I wanted so desperately just to have a simple white bread sandwich in my lunchbox, or at least a cool name for the creamy mush that I brought in, almost every day.
Socializing outside of school was similarly loaded. On the rare occasion my parents would let me go to a friend’s birthday party, I quickly learned that the cheese pizza would vanish first and I would almost never get enough. Chuckie Cheese’s pizzas were always layered with loads of pepperoni and ham and as a Muslim, I couldn’t eat it—there’s a dietary prohibition on pork in Islam. I learned later, after experience and a couple of misses, to always leave my game machine no matter how close to winning I was, and be one of the first ones at the table, so I could get first dibs on a slice of cheese pizza.
My childhood insecurities were my earliest cognizance of the implications food has in our culture and our lives. My childhood home’s food supply was ruled by an American-Lebanese health nut (my mother) who only gave us cookies from packages scrawled with the words “oatmeal” and “flaxseed,” and always made sure we had protein for breakfast before going to school, even if that protein came from a can of tuna at 7 a.m.! She took advantage of our Middle Eastern ethnicity (hence the hummus for lunch), using that cuisine’s traditional ingredients like olive oil, cracked wheat, and plain yogurt, and infusing them with some of the American recipes she would find in health magazines. The results, always beautiful homemade meals, and the aroma of freshly cooked ingredients, welcomed us every afternoon coming back home from a long day at school.
Her nutritional awareness, and cautiousness, stuck with me. Preventing my father’s organs from being ravaged by diabetes was dependent on the foods we ate as a family. As his children, we are also genetically predisposed to diabetes, so nutritional meals and good eating habits were of utmost importance.
The positive and negative of that food equation mattered, I realized. I used that realization, but not always in a productive way. My later relationship with food was altered by the culture and media around me. Regardless of the foundation my parents instilled in me as a child, the media was more powerful and had the upper hand. Magazines, television ads, and billboards always displayed the skinniest, most beautiful girls, even if the ad was for dog food! There was no escape. I didn’t know how I could channel my good and bad experiences about food until I decided I wanted to become a dietitian with a focus on eating disorders.
Upon agreeing to write this article, I decided to dig a little deeper past my own personal definition of culture. When you Google the word “culture,” multiple definitions come up: top stories on how MTV is gearing more towards the young culture; creating positive cultures in the work place; culture of cheese; and the biological culture of bacteria. The definition that held true throughout my research, and was pertinent to this article was “culture is a way of life of a group of people—the behaviors, beliefs, values, and symbols that they accept, generally without thinking about them, and that are passed along by communication and imitation from one generation to the next.”(https://www.tamu.edu/faculty/choudhury/culture.html)
Food consumption, restrictions, variety, and resources in a society, all affect that culture. As dietitians, therapists, or clinicians in this field, we must be thoroughly aware of our clients’ religious, and cultural backgrounds, to help build their trust in us, and be able to eventually help themselves through their personal recovery process. In my next part of this series, I will discuss the Hispanic and Asian ethnicities touching on cultural norms, dietary values, and common ingredients and foods used within each group. Religious sensitives of the Muslim, Jewish, Seventh Day Adventist, and Hindu population will also be broken down all in part to better prepare us before meeting with clients who identify to a specific faith or culture.
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